Urinary Sulfate Excretion and Late Graft Failure in Renal Transplant Recipients
1Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands
2Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, Netherlands
3Department of Epidemiology, University of Groningen, Groningen, Netherlands
4Department of Laboratory Medicine, University Medical Center Groningen, Groningen, Netherlands
5Department of Biomedical Research, University of Bern, Bern, Switzerland.
Meeting: 2018 American Transplant Congress
Abstract number: D88
Keywords: Graft failure, Renal function, Survival
Session Information
Session Name: Poster Session D: Kidney Complications: Late Graft Failure
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background
Hydrogen sulfide (H2S), produced from the metabolism of dietary sulfur-containing amino acids, is allegedly a potential renoprotective compound. High 24h urinary excretion of pathway intermediate metabolite thiosulfate (UTE) and end-metabolite sulfate (USE) may reflect higher H2S bioavailability. We aimed to investigate the associations of UTE and USE with graft failure in a large prospective cohort of renal transplant recipients (RTR).
Methods
We included 687 stable RTR, recruited at least 1 year after transplantation. We applied Cox regression analyses to study associations of UTE and USE, measured from baseline 24h urine samples, with graft failure. Estimated GFR (eGFR) was measured up to three times during follow-up. As sensitivity analysis, we applied mixed linear modeling to analyze the association of UTE and USE with eGFR over time.
Results
Median age was 55 [45-63] years, 57% was male, and mean eGFR was 45 (±19) ml/min. Median UTE and USE were 18.9 [14.9–22.6] [micro]mol/24h and 17.1 [13.1–21.2] mmol/24h respectively. During a median follow-up of 5.3 [4.5–6.0] years, 81 RTR experienced graft failure. Association of UTE with graft failure was less consistent and less prominent than the association of USE with outcome. High USE was associated with less graft failure (HR per doubling of USE: 0.44, 95% CI: 0.33-0.59, p<0.001). The association remained independent of adjustment for potential confounders. Sensitivity analyses showed that high UTE was associated with higher eGFR at baseline compared to low UTE, but not with eGFR change over time. High USE, however, was associated with better eGFR at baseline and less decline of eGFR over follow-up compared to low USE.
Conclusion
This study demonstrates a significant inverse association of USE with graft failure in RTR and suggests high dietary sulfur availability as a novel potentially modifiable factor for prevention of graft failure and decline of renal function in RTR.
CITATION INFORMATION: Said M., Post A., Minovic I., van Londen M., van Goor H., Postmus D., Heiner-Fokkema M., van den Berg E., Pasch A., Navis G., Bakker S. Urinary Sulfate Excretion and Late Graft Failure in Renal Transplant Recipients Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Said M, Post A, Minovic I, Londen Mvan, Goor Hvan, Postmus D, Heiner-Fokkema M, Berg Evanden, Pasch A, Navis G, Bakker S. Urinary Sulfate Excretion and Late Graft Failure in Renal Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/urinary-sulfate-excretion-and-late-graft-failure-in-renal-transplant-recipients/. Accessed May 9, 2025.« Back to 2018 American Transplant Congress